BMC Nephrology最新文献

{"title":"The effect of carvacrol on kidney injury caused by isopreterenol-induced myocardial infarction.","authors":"Gülhan Ünlü, Halime Tozak Yıldız, Osman Mert Yıldız","doi":"10.1186/s12882-025-04245-6","DOIUrl":"https://doi.org/10.1186/s12882-025-04245-6","url":null,"abstract":"<p><strong>Background: </strong>Myocardial infarction is a major cause of morbidity and mortality, often leading to heart and kidney dysfunction. Despite advancements in treatment, the link between heart and kidney damage is poorly understood. This study aims to evaluate the potential protective effect of Carvacrol, a natural bioactive compound, on kidney injury induced by myocardial infarction.</p><p><strong>Methods: </strong>In this experimental study, 32 male Wistar rats were divided into four groups: Control, Carvacrol (50 mg/kg), Myocardial Infarction (85 mg/kg isoproterenol), and Myocardial Infarction + Carvacrol (50 mg/kg Carvacrol + 85 mg/kg isoproterenol). Carvacrol was administered for six weeks, and myocardial infarction was induced with isoproterenol. Blood pressure, biochemical parametres (creatinin kinase, lactate dehydrogenase, urea, creatinine, GDF-15, IL-6), and kidney tissue histopathology were evaluated.</p><p><strong>Results: </strong>Biochemical analysis showed increased Creatinin Kinase and Lactate Dehydrogenase levels in the Myocardial Infarction group compared to controls(p = 0.023, p = 0.020), with carvacrol reducing these markers. IL-6 and GDF-15 levels were elevated in both the Myocardial Infarction and Myocardial Infarction + Carvacrol groups (p = 0.009, p < 0.001). Blood pressure was significantly reduced in the Myocardial Infarction group. Histopathological examination revealed severe kidney damage in the Myocardial Infarction group, while Carvacrol treatment showed less kidney damage, with only mild tubular dilation and rare necrosis.</p><p><strong>Conclusion: </strong>Carvacrol appears to have protective effects against kidney injury in myocardial infarction. It reduced myocardial injury markers and kidney damage, suggesting its potential therapeutic use in cardiorenal syndrome. Further studies are needed to understand its mechanisms and clinical applications in cardiovascular and renal diseases.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"295"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying and integrating consumer-prioritised topics and outcomes in clinical practice guidelines on managing kidney stones.","authors":"David J Tunnicliffe, Ieuan Wickham, Allison Jauré, Brydee Johnston, Andrew J Mallett, Adam Mullan, Lyn Lloyd, Nicole Scholes-Roberston, Hicham Cheikh Hassan, Matthew Jose","doi":"10.1186/s12882-025-04160-w","DOIUrl":"https://doi.org/10.1186/s12882-025-04160-w","url":null,"abstract":"<p><strong>Aim: </strong>The prevention and management of recurrent kidney stones can be challenging and requires patients to modify their diet and daily rountines that impact their quality of life. Our study aims to describe the process of integrating consumer-prioritised topics and outcomes in guidelines on kidney stones to ensure patient relevance.</p><p><strong>Methods: </strong>Two workshops were convened in Aotearoa New Zealand with people with kidney stones invited to identify topics and outcomes for inclusion in the guidelines. Flipcharts and transcripts were analysed thematically to identify the reasons for participants' choices.</p><p><strong>Results: </strong>The topics identified by the twenty-eight participants included education on nutrition, better diagnosis, and individualised nutritional and pharmacological management. Pain, equity of access, anxiety about recurrence, and life participation were identified as important outcomes to be included. Four themes (and subthemes) underpinning priorities were: unresolvable debilitating pain (complexity of exctruciating acute episodic pain, inadequacy of pain relief medication, frustrated by stigma associated with opioids), dissatisfied at delayed access to care (prolonged difficulties in diagnosis, struggling to obtain individualised care), inadequate knowledge to enable self-management (insufficient information on kidney stones, conflicting nutrition advice, cultural deficit), and limiting life participation (restricting life choices, psychological burden of kidney stones).</p><p><strong>Conclusions: </strong>Participants identified topics that would support symptom management to improve quality of life and reduce the burden on families. Guidelines should provide essential, consistent and clear guidance, particularly on nutrition, to support self-management. Incoporating consumer priorities in guidelines can help to support decision-making and patient-centred care in kidney stones.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"292"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involvement of dysregulated RNA binding protein and alternative splicing regulatory networks in diabetic nephropathy from type 2 albuminuric cohorts.","authors":"Yu Wang, Jingjing Zhang, Qian Tang","doi":"10.1186/s12882-025-04237-6","DOIUrl":"https://doi.org/10.1186/s12882-025-04237-6","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN) is a primary contributor to end-stage renal disease, yet the underlying molecular mechanisms remain incompletely understood. This study aims to elucidate the role of RNA-binding proteins (RBPs) and RBP-alternative splicing (AS) regulatory networks in the pathogenesis of DN.</p><p><strong>Methods: </strong>Two RNA-seq datasets (GSE117085 and GSE142025) were retrieved from the Sequence Read Archive (SRA) database. Regulated alternative splicing events (RASEs) and genes (RASGs) of RASEs, along with differentiated RBPs, were identified. Validated differentiated RBPs were correlated with clinical features using the Nephroseq v5 online platform. Using the DN mouse model and RT-qPCR, validated the alternative splicing of RNA.</p><p><strong>Results: </strong>Our analysis revealed 15 differentiated RBP genes and 423 RASEs in the kidney cortex of DN rats compared to controls. Enrichment analysis highlighted lipid metabolism pathways for RASGs. Seven of the identified RBPs were validated in kidney biopsy samples from DN patients versus controls. A co-deregulatory network was constructed based on dysregulated RBPs and RASEs, with select RASGs identified. In vivo experiments, compared to normal mice, the mRNA levels of RPS19 were significantly elevated in the renal tissues of DN mice, while the levels of CPEB4 and CRYZ were markedly decreased.</p><p><strong>Conclusion: </strong>In conclusion, this study provides evidence implicating dysregulated RBPs and RBP-AS regulatory networks in the development of diabetic nephropathy. The validated RBPs exhibited close associations with clinical biomarkers, reinforcing their potential as therapeutic targets for DN. These findings enhance our understanding of the molecular basis of DN and offer new insights for future research and intervention strategies.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"326"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An explainable machine learning model for early warning of hypertensive and hypotensive anomalies in maintenance hemodialysis patients.","authors":"Zhuoyu Li, Siying Hao, Shujun Shi, Lin Li, Ziwei Tao","doi":"10.1186/s12882-025-04270-5","DOIUrl":"https://doi.org/10.1186/s12882-025-04270-5","url":null,"abstract":"<p><strong>Background: </strong>Intradialytic hypotension (IDH) and intradialytic hypertension (IDHTN) are major complications of maintenance hemodialysis (MHD) that significantly impact patient morbidity and mortality. Effective, explainable prediction of IDH and IDHTN can improve their management.</p><p><strong>Methods: </strong>This study introduces a dual-model system for predicting IDH and IDHTN, using SHAP (SHapley Additive exPlanations) to enhance explainability. We analyzed data from maintenance dialysis patients at the Second Hospital of Lanzhou University, covering treatments from February 2019 to August 2023. Two models were developed: Model A, with a small set of easily obtainable features, and Model B, with a comprehensive set of multidimensional features.</p><p><strong>Results: </strong>The study cohort included 193 patients and 45,825 dialysis samples, with an average age of 54 years and 66.32% male. Model A used 12 features, while Model B used 51. Models were trained using XGBoost, Random Forest, logistic regression, and KNN. Random Forest achieved the highest AUROC of 0.7160 in Model A. XGBoost reached an AUROC of 0.7412 in Model B. SHAP analysis identified key predictors such as pre-dialysis blood pressure, lactate dehydrogenase, and age. Older patients (>60 years) were at higher risk for hypotension. A larger gradient between plasma sodium and dialysate sodium was associated with increased IDH risk and required more aggressive ultrafiltration. Adjusting the sodium gradient through dialysate sodium concentration may help manage IDHTN risk.</p><p><strong>Conclusions: </strong>This study demonstrates that explainable AI models can predict IDH and IDHTN risks accurately before treatment, potentially reducing severe adverse events and improving patient outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"318"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal dialysis related peritonitis caused by commensal neisseria species: a retrospective case series.","authors":"Ying Liu, Yuan Feng, Yanting Yu, Qiuyuan Shao, Sixiu Liu, Qingyan Zhang, Chunming Jiang","doi":"10.1186/s12882-025-04234-9","DOIUrl":"https://doi.org/10.1186/s12882-025-04234-9","url":null,"abstract":"<p><strong>Background: </strong>Commensal Neisseria species are increasingly recognized as invasive pathogens. Neisseria peritoneal dialysis (PD) related peritonitis is extremely rare, and its clinical course remains unclear. This study aimed to provide an overview of the clinical characteristics and coutcomes of Neisseria peritonitis.</p><p><strong>Methods: </strong>This single-center study retrospectively reviewed all Neisseria peritonitis episodes diagnosed from 1 January 2014 to 31 March 2024. Demographics, biochemical data and clinical outcomes were recorded.</p><p><strong>Results: </strong>During this period, 433 episodes of peritonitis were recorded, 13 (3.0%) of which were caused by Neisseria species. All patients had hypoproteinemia, and 63.64% of them had diabetes. More than half of the peritonitis cases occurred in winter (7/13). N. sicca was the most common species identified. 3 episodes of peritonitis were related to contamination during exchange procedures. 8 patients achieved primary response using amikacin or ceftizoxime, 2 patients were cured by switching amikacin to ceftriaxone and 1 patient had the catheter removed due to three episodes of Neisseria peritonitis within six months.</p><p><strong>Conclusions: </strong>Neisseria species can cause PD related peritonitis, and contamination during PD exchange is a plausible transmission route. Our study suggests that empirical therapy with amikacin or third-generation cephalosporins may achieve complete cure in most cases. While the overall outcome of Neisseria peritonitis is generally favorable, biofilm formation warrant special clinical attention due to potential treatment challenge.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"313"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role and mechanism of TSC in kidney diseases: a literature review.","authors":"Qiulin Luo, Xinguo Zheng, Ye Xu, Yuxi Fan, Hedong Zhang, Tengfang Li, Xiangqi Zhang, Longkai Peng, Xin Jiang, Helong Dai","doi":"10.1186/s12882-025-04260-7","DOIUrl":"https://doi.org/10.1186/s12882-025-04260-7","url":null,"abstract":"<p><strong>Background: </strong>Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder characterized by multisystem involvement, primarily caused by loss-of-function mutations in the TSC1 or TSC2 genes. TSC is a key integrator of metabolic signaling and cellular stress and has become an important regulator in several kidney diseases. TSC1 and TSC2 can be used not only as genetic markers for disease diagnosis, but also as potential immunotherapeutic targets for kidney disease. Recent studies on the pathogenesis of TSC may provide guidance for developing new treatment strategies for kidney diseases.</p><p><strong>Key messages: </strong>Therefore, we systematically reviewed the molecular biology of TSC and their signaling pathway, regulation of cell metabolism, and immune response in acute renal injury, chronic kidney disease, diabetic kidney disease, renal cysts, benign and malignant intrarenal tumors, and renal angiomyolipomas. We also summarize the efficacy and adverse effects of mTOR inhibitors in the treatment of TSC-related kidney diseases.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"316"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic implications of systemic immune-inflammation index and systemic inflammation response index in hemodialysis patients.","authors":"Qianqian Zhu, Liang Dai","doi":"10.1186/s12882-025-04223-y","DOIUrl":"https://doi.org/10.1186/s12882-025-04223-y","url":null,"abstract":"<p><strong>Objectives: </strong>Patients undergoing hemodialysis (HD) face high mortality, mainly from cardiovascular disease (CVD), infections, and dialysis withdrawal. Systemic inflammation contributes significantly to these outcomes. This study aimed to examine the associations between the systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) with all-cause, CVD, and infection-related mortality in HD patients, and to evaluate their prognostic value.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 1190 HD patients recruited between January 2012 and December 2016. Kaplan-Meier survival curves, Cox regression analysis, and restricted cubic spline (RCS) models were employed to explore the associations between SII, SIRI, and all-cause, CVD, and infection-related mortality. In addition, receiver operating characteristic (ROC) curves was used to determine the predictive accuracy of SII and SIRI.</p><p><strong>Results: </strong>Among the 1190 patients (median age 62.0 years; 64.0% male), the all-cause mortality rate was 38.2%, while the CVD mortality rate was 16.9%. Adjusted Cox regression analyses revealed that patients in the highest SIRI quartile (quartile 4) had significantly elevated risks of all-cause (hazard ratio [HR] 2.29, 95% CI 1.38-3.80, P = 0.001), CVD (HR 3.78, 95% CI 1.43-10.01, P = 0.007), and infection-related mortality (HR 2.42, 95% CI 1.70-3.01, P < 0.001) compared to those in the lowest SIRI quartile. Similar associations were found for SII (P < 0.001). Kaplan-Meier curves demonstrated comparable results. RCS analysis revealed nonlinear relationships between SII, SIRI, and mortality risk (P < 0.05). ROC analysis highlighted that Both SII and SIRI demonstrated moderate to strong prognostic value, with SIRI consistently offering the best risk stratification.</p><p><strong>Conclusions: </strong>Elevated levels of SII and SIRI are linked to higher risks of all-cause, CVD, and infection-related mortality in HD patients. SIRI appears to be a more reliable predictor of mortality risk. Future studies should explore the underlying mechanisms and validate the predictive value of SII and SIRI for mortality risk among HD patients.</p><p><strong>Clinical trail number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"322"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of Malnutrition-Inflammation Score with sleep quality and mental health in hemodialysis patients: a multicenter cross-sectional study.","authors":"Mehrnaz Morvaridi, Hossein Bavi Behbahani, Meysam Alipour, Ahmad Zare Javid, Sara Keramatzadeh, Shiva Shokri, Pardis Tofighzadeh, Fatemeh Fayazfar, Haleh Soltaniyan Dehkordi, Elahe Ghadimi, Siavash Babajafari Esfandabad, Shokouh Shayanpour","doi":"10.1186/s12882-025-04089-0","DOIUrl":"https://doi.org/10.1186/s12882-025-04089-0","url":null,"abstract":"<p><strong>Background: </strong>Hemodialysis is crucial for individuals with end-stage renal disease (ESRD), but it poses challenges that impact health and quality of life. Malnutrition, inflammation, sleep disturbances, and mental health disorders are common among hemodialysis patients, interconnecting and influencing outcomes. Therefore, the study aimed to investigate the association between the Malnutrition-Inflammation Score (MIS) and various health parameters, including sleep quality and mental health in hemodialysis patients.</p><p><strong>Methods: </strong>A multicenter cross-sectional study investigated the association between the MIS and health parameters in 423 hemodialysis patients across eight centers. Assessments included MIS, physical activity levels, dietary intake, sleep quality, and mental health status, along with biochemical parameters. Statistical analyses using SPSS software were conducted to identify associations.</p><p><strong>Results: </strong>Significant differences were observed in demographic, clinical, and biochemical characteristics across MIS quartiles (p < .05). Older age, lower BMI, longer dialysis vintage, and altered biochemical profiles were noted in higher MIS quartiles. Depression scores were significantly higher in higher MIS quartiles (p = .04). Multivariable analyses confirmed these associations, indicating higher odds of poorer sleep quality, depression, and anxiety with increasing MIS quartiles (p < .05).</p><p><strong>Conclusion: </strong>The study highlights the intricate association between malnutrition, inflammation, sleep quality, and mental health conditions in hemodialysis patients. Addressing these factors comprehensively and tailoring interventions may lead to improved outcomes and well-being.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"305"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The complex diagnosis of post-dialysis fever: a case report and literature review of infective endocarditis in a dialysis patient.","authors":"Xinyu Wang, Yu Xie, Meiyu Chen, Hongyan Zhu, Guonian He, Wenjing Yu, Dan Qiao, Ying Shen, Lu Song, Qinyuan Deng","doi":"10.1186/s12882-025-04236-7","DOIUrl":"https://doi.org/10.1186/s12882-025-04236-7","url":null,"abstract":"<p><strong>Background: </strong>Post-dialysis fever is a common but diagnostically challenging issue in hemodialysis patients, with potential causes including dialysis-related infections, pulmonary infections, and cardiovascular complications.</p><p><strong>Case presentation: </strong>We report a 76-year-old male with end-stage renal disease (ESRD) on maintenance hemodialysis, coronary artery disease, and prior cardiac stent implantation, who presented with recurrent post-dialysis fever. Despite persistently negative conventional cultures, metagenomic next-generation sequencing (NGS) of pre-dialysis blood samples identified Pseudomonas aeruginosa (P. aeruginosa), Cutibacterium acnes (C. acnes; formerly Propionibacterium acnes), Staphylococcus epidermidis (S. epidermidis), and Corynebacterium accolens (C. accolens) and Epstein-Barr virus (EBV), while post-dialysis samples revealed only C. acnes and EBV. Given the temporal association with fever, these two pathogens were considered the primary causative agents. Subsequent transesophageal echocardiography (TEE) confirmed aortic valve vegetations, establishing the diagnosis of infective endocarditis (IE). Following targeted antimicrobial and antiviral adjustments based on NGS findings, the patient exhibited complete resolution of post-dialysis fever and was discharged. However, as the vegetation was not surgically removed, he was hospitalized multiple times over the following five months for recurrent infections and ultimately died of septic shock and multi-organ failure due to carbapenem-resistant Klebsiella pneumoniae.</p><p><strong>Conclusions: </strong>This case underscores the complementary role of TEE and NGS in diagnosing IE in high-risk patients, enabling the detection of uncommon pathogens and informing targeted therapy to improve clinical outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"331"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unclassified renal cell carcinoma with multi-organ metastasis treated with surgery and targeted therapy combination: a case report and literature review.","authors":"Gonglin Tang, Jianing Sun, Rui Yang, Xin Chen, Gang Wu, Hongwei Zhao","doi":"10.1186/s12882-025-04274-1","DOIUrl":"https://doi.org/10.1186/s12882-025-04274-1","url":null,"abstract":"<p><p>We present a rare case of unclassified renal cell carcinoma (RCC) in a 66-year-old woman, exhibiting multi-organ invasion. The patient was asymptomatic until a health exam revealed a left renal mass. CT scans showed an irregular, 6.8 × 8.9 cm mass involving the renal sinus, with possible pancreatic infiltration and retroperitoneal lymph node metastasis. Intraoperative findings necessitated multi-organ resection, including the left kidney, spleen, and portions of the pancreas. Histopathology confirmed unclassified RCC, positive for CA-9, CD10, Vim, and negative for P504S, CD99, Desmin. Post-surgery, the patient received cabozantinib and nivolumab, and remains progression-free at 22 months of follow-up. This case analyzed the diagnosis and treatment of aggressive unclassified RCC, and showed good efficacy after extensive surgical resection and combined treatment with cabozantinib and nivolumab, which may help further study of unclassified RCC.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"300"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}